中国医师协会骨科医师分会骨科循证临床诊疗指南:成人急性胸腰段脊柱脊髓损伤循证临床诊疗指南

摘要

In order to provide the clinical guidelines of acute thoracolumbar injury for the Chinese orthopedic surgeons,the Spine Trauma Group of Chinese Association of Orthopedic Surgeons compiled this guideline.The guideline applies to adult patients with acute (less than 3 weeks) thoracolumbar fracture and(or) dislocation with or without spinal cord,cauda equina or nerve root injuries.The Study Group wrote the guideline by setting up questions,determining search words,screening literatures according to inclusion and exclusion criteria,analyzing the included literatures,confirming evidence levels and then providing recommendations.The guideline include 247 literatures,of which 35 articles were in Chinese and 212 articles were in English.The guidelines set up 20 questions divided into 4 sections:pre-hospital care,diagnosis and evaluation,treatment and prevention of complications,which include 39 recommendations.%为了给中国的骨科医师提供急性胸腰段脊柱脊髓损伤的循证临床诊疗建议,中国医师协会骨科医师分会脊柱创伤工作组组织相关专家撰写了本指南.本指南适用于3周内的成人外伤性胸腰段脊柱骨折和(或)脱位,合并或不合并脊髓、马尾神经、神经根损伤,不包括未成年患者、低能量损伤、无骨折脱位胸腰段脊髓损伤、病理性及合并强直性脊柱炎的骨折脱位.工作组通过设置问题、确定检索词来检索中英文文献,按照纳入和排除标准筛选文献,详细分析最终纳入的证据文献,确定证据等级,给出相应的推荐建议.本指南最终纳入247篇文献,其中中文35篇,英文212篇;设置了20个问题,分为院前急救、诊断与评估、治疗和并发症防治四大部分,共39个推荐条目.